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Categories of tissues
Covering Epithelia
Simple squamous
Simple cuboidal
Simple columnar
Stratified squamous
Stratified columnar
Pseudostratified columnar
Glandular Epithelia
Exocrine glands
Endocrine glands
Pancreas
Merocrine
Apocrine
Holocrine
Connective Tissues
Connective tissue
Collagen
Dense CT
Dermis
Capsules
Tendons
Stroma of cornea
3. Tumor
Swelling
4. Dolor
Pain
Fluid extravasation
Sensory nerves
Loss of function
Destruction of functional units
Acute inflammation
Vascular & exudative
---(Tissue)---> Microphages
Subchronic inflammation
Intergrade between acute & chronic
Chronic inflammation
Vascular & fibroblastic
---(Tissue)---> Macrophages
Inflammation according to Characterisics of Exudate
Serous inflammation
Serum/secretions from serosal mesothelial cells (3Ps)
Pulmonary TB
Fibrinous inflammation
Diphtheria, rheumatoid pericarditis
Early stage of pneumonia
Catarrhal inflammation
Hypersecretion of mucosa
Hemorrhagic inflammation Blood + exudates
Bacterial infections & other infections
Suppurative/purulent
inflammation
5. Functio laesa
Dysplasia
Anaplasia/
Dedifferentiation
Neoplasia/tumor
Oncology
Parts of a tumor
Types of tumor
Benign
Malignant
Leukemia
Lymphoma
Squamous cell papilloma
Squamous cell carcinoma
Hepatoma/
hepatocarcinoma
Melanoma/
melanocarcinoma
Ectopic pregnancy
Grading
Grade
I
II
III
IV
Staging
UICC
AJCS
TNM system
T
Reversible
One type of adult cell Changes in structural components
Irreversible
Criterion toward malignancy
Adult cell More primitive cells (release tumor markers)
Continuous abnormal proliferation of cells w/o control (no purpose/function)
Ex. Leukemia
Study of neoplasm
Tumors
1. Parenchyma = active elements (tumor cells)
2. Stroma = CT framework
1. Capacity to produce death:
- Benign (Ex. mole)
- Malignant
2. Histologic characteristics:
- Medullary = cells (parenchyma) > supporting tissues (stroma)
- Scirrhous = supporting tissues (stroma) > cells (parenchyma)
-oma
SaMe CarE
-sarcoma = mesenchymal/CT
-carcinoma = epithelial tissues
Malignant
Benign
Malignant
Malignant
Malignant
Fallopian tube pregnancy
Grading
Aggressiveness/level of malignancy
Differentiated cells = resemble normal cells
Undifferentiated cells = younger cells
Broders Classification (Grading)
Differentiated Cells
Undifferentiated Cells
75-100%
0-25%
50-75%
25-50%
25-50%
50-75%
0-25%
75-100%
Staging
Size, extent of spread to lymph nodes, +/- metastases
TNM classification
Grading + staging
TNM System
Applicable to all forms of neoplasia
1 tumor
#: denotes the size of tumor and its local extent
Tis = carcinoma in situ
Ta = non-invasive
Tx = cannot be evaluated
T0 = free of tumor
Treatment
Surgery
Radiation
Teratomas
Apoptosis
Necrobiosis
Necrosis
Types of Necrosis
Coagulation necrosis
Liquefaction/colliquative
necrosis
Caseous/caseation necrosis
Gangrenous necrosis
Fat necrosis
Fatty degeneration
1 changes
2 changes
Algor mortis (1st)
Cooling: 7F/hr
Rigor mortis
Stiffening
1st: neck & head (2-3 hrs)
Persists for 3-4 days
Livor mortis
Lividity/suggillations
Purplish discoloration
After 10-12 hrs, it does not blanch on pressure or shift when the body is moved
Postmortem Lividity vs. Ecchymosis
Postmortem Lividity
Ecchymosis
Disappears on pressure (reappears when pressure is Opposite of postmortem lividity
released)
Oozing of blood (incision)
No oozing of blood (incision)
Postmortem Clot vs. Antemortem Clot
Postmortem Clot
Antemortem Clot
Settling of RBCs from plasma
Not readily detachable from the blood vessels
Chicken fat
No chicken fat
Currant jelly
No currant jelly
Assumes the shape of the vessel
Seldom assumes the shape of blood vessels
Rubbery consistency
Granular & friable
Dessication
Drying & wrinkling of the anterior chamber of the eye
Putrefaction
Invasion of intestinal microorganisms
Autolysis
Self digestion of cells
Lysosome: suicide sac of the cell, releases lysozyme
Organ Weights
Liver
1,100 1,600g
Brain
1,150 1,450g
Right lung
300-400g
Left lung
250-350g
Heart
250-300g
Spleen
60-300g
Thyroid
10-50g
Adrenals
4g or so each
Exfoliative Cytology
Exfoliative cytology
Desquamated cells
Pap smear stain method
Method of choice
Barr body
PAP smear
3 anatomical sites
1. Upper lateral third of the vagina
2. Ectocervix
(Stratified Squamous Epithelium)
--------------------------------T zone: detect cervical cancer-------------------------------(Simple Squamous Epithelium)
3. Endocervix
50% alcohol = All types
Fixation
50% alcohol = pleural & peritoneal
70% alcohol = sputum
95% alcohol = urine, bronchial & gastric
Saccomannos fixative = 50% ETOH + 2% carbowax
Smear preparation
Fix immediately
2-3 slides/patient
a. streaking
b. spreading
lec.mt 04 |Page | 260
(2nd)
Fixing smear
Sputum
BAL
Jelly-like clots
GI specimen
Urine
Pap smear
Adhesive agents
3 primary materials used
for obtaining specimen for
Pap smear
Strawberry cervix
Intermediate cells
c. touch preparation/impression
d. pull-apart
Never touch the bottom of the fixative container
Equal parts of ethanol & ether = BEST (but highly flammable)
95% ethanol = commonly used
Spray fixatives = 1 ft away
Saccomannos fixative
3 specimen
(+) alveolar macrophage = sputum
(-) alveolar macrophage = saliva
P. carinii/P. jiroveci
Prevent by adding 300U heparin/100mL aspirate
If > hr delay of fixation digestion of cells
Fasting: 8 hrs
50mL = cytology
10-15mL = UA
2nd urine = preferred
Dr. George Papanicolau (1940)
Smears: prepared by rotary motion
1. Mailing of specimens
- air drying after 2 hrs fixation
- glycerin technique
2. Egg albumin = not recommended as adhesive agent (intensifies stain by Light
Green)
Pooled human serum/plasma
Celloidin ether alcohol
Leuconostoc culture
1. Speculum
2. Ayers spatula = rotate 3600
3. Cytobrush = Os
T. vaginalis
Cells (Cervicovaginal Smears)
Parabasal | Intermediate | Superficial
----------Estrogen----------
45-50m
Pyknotic nucleus
True acidophilia
Folds/curls on edges
a. Navicular cells = boat-shaped
Parabasal cells
15-30m
Fried eggs w/ sunny side up
Endometrial cells
Groups of 3 or more
1-10 days after menst
Endocervical glandular cells Honeycomb appearance
Similar appearance to parabasal cells
lec.mt 04 |Page | 261
Doderlein bacillus
L. acidophilus
Paps stain: blue to lavender
Diabetic patients
Sish kebab appearance
Pear-shaped, blue-gray to blue-green
Pigs on a scruff appearance
Indicates T. vaginalis infection
Clue cells
Wrinkled prune appearance
w/ perinuclear halo
HPV (LSIL)
Formation of salt crystals
C. albicans
T. vaginalis
Leptothrix
G. vaginalis
Koilocytes
Ferning
Early pregnancy
Quantitative Evaluation: Cytohormonal Maturation Index (CHMI)
MI = P/I/S
CHMI
Pregnancy
Newborn (8 weeks)
Infancy (8 weeks-puberty)
Late menopausal
75 y.o. woman w/ estrogen
therapy
3 copies/report
1. Doctor
2. Patient = original copy
3. File
Reports
Surgical pathology report
Cytopathology report
Autopsy report
Signatories
Request forms = patients doctor
Result forms = pathologist
Turnover of results
Surgical pathology & cytology = 24 hrs
Frozen section = 5-15 mins
Autopsy report = 1 week (Autopsy procedure: 24 hrs)
Storage
Specimen (tissue) = 1 month to 1 year
Tissue blocks (paraffin) = 3 to 10 years
Slides = indefinite
Suggested Guidelines for Record and Specimen Retention (Henry, 21st Ed.)
Records
Requisitions
2 years
QC
2 years
Instrument maintenance
2 years
BB QC
5 years
BB employee signatures
10 years
BB donor/recipient records Indefinitely
Reports
Clinical pathology lab
2 years
reports
Surgical pathology (and
10 years
BM) reports
Cytogenetics reports
20 years
Autopsy forensic reports
Indefinitely
lec.mt 04 |Page | 262
Specimens
Serum/other body fluids
Blood smears (routine)
Microbiology smears
BB donor/recipient
specimens
Pathology/BM slides
Pathology blocks
Cytogenetic slides
Cytogenetics diagnostic
images
Forensic Cases
Body fluids
Tissue for toxicology
Wet tissues
Paraffin blocks
Slides
Reports
Gross photographs/
negatives
Dried blood films
Frozen tissue for DNA
Autopsy
Types of autopsy
48 hours
7 days
7 days
7 days post-transfusion
10 years
10 years
3 years
20 years
1 year
1 year
3 years
Indefinitely
Indefinitely
Indefinitely
Indefinitely
Indefinitely
indefinitely
Autopsy (Postmortem Examination)
Gold standard for confirmation of a medical disease
Wherever scientific medicine of high quality is practiced, postmortem exams
are performed
Whenever a conscientious physician knows why he lost his patient, a
postmortem exam has been performed
Whenever criminal law is enforced
Whenever a death certificate shows accurately the causes of death & confirmed
medical diagnosis for the assembling of vital statistics, a postmortem has been
performed
Whenever there is medical research on the causes & nature of diseases such as
cancer, heart diseases & stroke, the investigative method is the postmortem
exam
An informed society requires a postmortem exam in human death for the good
of medical science, for the publics health & for the future care of the living
patient
1. Complete autopsy
- Requires consent
- Complete examination of all organs, including the brain
2. Partial autopsy
- Part of the anatomy
3. Selective autopsy
- Restricted to at least a single organ (Ex. MI heart)
1. Written consent from the next kin-abide by the extent or restrictions allowed
- Relative: oriented by the attending physician, not the pathologist
2. Death certificate (Old: Blue form | New: Blue border/frame)
- Signed by:
a. Physician
b. Pathologist (back): will sign when PME has been performed
3. Medical abstract or clinical data
lec.mt 04 |Page | 263
4. Medico-legal clearance
- Suspicious evidence of foul play
- Ex. physical injury
Other Uses of Death
Certificate
If pathologist is not
available
The coroner has authority
in the following cases
Somatic death
Criteria for the
pronouncement of death
Postmortem changes
Technique of Virchow
Technique of Rokitansky
Technique of Ghon
Technique of Letulle
Teasing/Dissociation
Crushing/squash
preparation
Smear preparation
Frozen section
Freezing of unfixed tissue
Freezing of fixed tissue
Formal (formol) calcium
Commonly used methods of
freezing
Staining methods
(frozen sections)
H&E
Freeze-drying
Freeze-substitution
Cold knife procedure
Cryostat procedure
(Cold microtome)
O.C.T. (Optimal Cutting
Temperature)
Steps
Fixation
pH
Temperature
Microanatomical fixatives
Cytological Fixatives
Nuclear fixatives
Cytoplasmic fixatives
Tissue Processing
FDCIETS SMoL
1. Fixation
(Decalcification)
2. Dehydration
3. Clearing/Dealcoholization
4. Impregnation/Infiltration
5. Embedding/Casting/Blocking
6. Trimming
7. Sectioning/Microtomy
8. Staining
9. Mounting
10. Labeling (slides)
Fixation
st
1 and most critical step
1 aim: preserve cell (life-like)
2 aim: harden & protect tissues
Most important: stabilization of proteins
6.0-8.0
Room temp = Surgical specimen
0 to 4C = EM and Histochem.
General microscopic study of tissues
a. 10% Formol saline
b. 10% NBF
c. Heidenhains SuSa
d. Formol sublimate (formol corrosive)
e. Zenkers solution
f. Zenker-formol (Hellys)
g. Bouins solution
h. Brasils solution
Specific parts of the cell
a. Nuclear fixatives: w/ glacial acetic acid destroys mitochondria & golgi
bodies (pH 4.6)
b. Cytoplasmic fixatives: w/o glacial acetic acid
c. Histochemical fixatives: preserves chemical constituents
BFNCH
Bouins
Flemmings w/ acetic acid
Newcomers
Carnoys
Heidenhains SuSa
HORFF
Hellys
Orths
Regauds
lec.mt 04 |Page | 267
Histochemical fixatives
Aldehyde Fixatives
Formaldehyde
Formol-Corrosive
(formol sublimate)
Glutaraldehyde
Karnovskys
paraformaldehydeglutaraldehyde
Acrolein
Formol-calcium
Mercuric Chloride
Heidenhains SuSa
HgCl2
G.HAc
De-zenkerization
Chromate fixatives
Chromate pigments
Lead fixatives
Picric acid fixatives
Osmium tetroxide
(Osmic acid)
Trichloroacetic acid
Acetone
Heat fixation
2 fixation
Post-chromatization
Washing out
EM fixatives
Stains (EM)
(+) Fat
(+) Blood
Cold temperature
Enhanced by:
Size & thickness
Agitation
Automatic/mechanical tissue processing
Moderate heat
37-56C
Principles and Precautions in Handling and Fixation of Specimens in General
Autopsy materials
Fixed ASAP
If not possible mortuary refrigerator (4C) or arterial embalming
Surgical specimens
Fixed ASAP
If not possible refrigerate
If placed in NSS during
Autolysis may occur before fixation
operation
If tissues are refrigerated
Avoid slow freezing (ice crystal formation)
Repeated freezing & thawing destroy organelles, release enzymes
Not more than 5mm thick
Size of tissues
Except lung edema: 1-2 cm thick
20:1
Ratio of fixative to tissue
Except osmium tetroxide (expensive) = ratio is 5-10:1
50-100:1
Ratio of fixative to tissue in prolonged fixation (ex. museum preparation)
Avoid drying of small tissue To prevent: place in a petri dish w/ moistened filter paper
biopsies
Hollow organs
Stomach, intestines
Packed w/ cotton soaked fixative or completely opened before being immersed
in adequate fixing solution
Air-filled lungs
Float on fixative
To prevent: cover w/ several layers of gauze to maintain it under surface
Human brains
Suspended by a cord tied under the Circle of Willis to prevent flattening
Avoid Ringers lactate for washing out of blood intravascular perfusion
Fixation time: 2 weeks
Eyes
Not dissected before fixation tissue collapse & wrinkling (escape of vitreous
humor)
Inject formol-alcohol before immersing the organ in the fixative
Glycogen-containing tissues Do not use water
Glycogen is water-soluble
Hard tissues
Cervix, uterus, fibroids, hyperkeratotic skin, fingernails
Wash in running water overnight immerse in 4% aqueous phenol for 1-3
days (Lendrums method)
Difficulties Encountered because of Improper Fixation
Problem
Cause
Failure to arrest early cell autolysis
Failure to fix immediately (tissue was allowed to dry
before fixing)
Insufficient fixative
lec.mt 04 |Page | 270
HNO3
5% Formic acid
HCl (Von Ebners)
EDTA
Ion exchange resins
Electrophoresis
Measuring extent of
decalcification
Post-Decalcification
Tissue softeners
Color
Brown/black granules
Removed by:
SAKaL
a. Saturated picric acid
b. Alcoholic KOH
c. Kardasewitsch method
d. Lillies method
Black granules
Alcoholic iodine
Fine, yellow brown
Acid-alcohol
Black precipitate crystals
Cold H2O
Intense eosinophilic staining at the center of the tissue (H & E)
Due to partial coagulation of partially fixed protein
Decalcification
Ratio of decalcifying agent to tissue
Impaired nuclear stain by Van Giesons stain
Tissue Digestion (24-48 hrs)
Optimum temperature
Time
Acids
Chelating agents (EDTA/versene)
Ion exchange resins
Elec. ionization (electrophoresis)
Most common
a. Perenyis = tissue softener & decalcifying agent
b. Phloroglucin-HNO3 = most rapid
- Disadvantage: Yellow color on tissue (neutralize w/ sodium thiosulfate)
Both fixative & decalcifying agent
Best general decalcifying agent
For small pcs of bones & teeth
For small pcs of bones & teeth
For surface decalcification (HCl)
For EM, IHC, & enzyme staining
Hastens decalcification by removing calcium ions from formic acid-containing
decalcifying solutions
Ca2+ are attracted to negative electrode (cathode)
Physical method
Chemical method = CaOx test (routine) | Turbidity = (+) Ca2+
X-ray = most ideal, most sensitive, most reliable but very expensive
- X-ray paper = Kodak X-omat or Faxitron
Removal/neutralization of acid from the tissues after decalcification
Lithium carbonate or sodium bicarbonate solution
4% phenol
Molliflex = tissues appear swollen & soapy
2% HCl
lec.mt 04 |Page | 271
Dehydration
10:1
Ethanol
Methanol
Butanol
Denatured alcohol
Acetone
Dioxane
(Diethylene dioxide)
Tetrahydrofuran (THF)
Graupners method
Weisebergers method
Cellosolve
Triethyl phosphate
Additives to dehydrating
agents
Methods of determining
incomplete dehydration
Xylene (Xylol)
Toluene
Chloroform
Benzene
Methyl salicylate
Methyl benzoate
Cedarwood oil
Clove oil
CCl4
Aniline oil
Glycerin
Gum syrup
Others
25:1
Medium
Paraffin
Paraffin filters
Paraffin oven
Blocking-out Molds
Leuckharts embedding
mold
Compound embedding unit
Plastic embedding rings &
basse mold
Tissue Tek
Disposable embedding
molds
Celloidin/Nitrocellulose
method
Double embedding method
2 L-shaped strips
Adjustable
Several compartments
Special stainless steel base mold fitted w/ a plastic embedding ring (block
holder)
Warm plate
Cold plate (-5C)
1. Peel-away: perfect even block w/o trimming
2. Plastic ice trays: ordinary refrigerators
3. Paper boats: cheap & easy to make
Bones, teeth, eyes
Bell jars: control evaporation
1st: celloidin
2nd: paraffin
Brain
Recall Temperatures
Knife = -40 to -60C
Tissue = 5 to -10C
Environment = 0 to -10C
-18 to -20C
Surgical specimen: room temp
HC & EM: 0-4C
Quenching: -160C
Sublimation: -40C
7F/hr (3.89C/hr)
4C
Manual = 2-5C above MP of wax (55-60C)
Automated = 3C above MP of wax
Vacuum = 2-4C above MP of wax
5-10C above MP of wax
6-10C below MP of wax (45-50C)
Trimming
Removing excess wax after embedding
Ideal: four-sided prism/truncated pyramid
Microtomy
4-6m
10-15m
0.5m
Trefall
Simplest
Minot
Most commonly used for paraffin embedded tissues
Adams
Most dangerous (movable knife)
a. Base-sledge
- For all forms of media
- Block: moving
- Knife: stationary
b. Standard sliding
- Block: stationary
- Knife: moving
lec.mt 04 |Page | 274
Vibrotome
Ultrathin microtome
Freezing microtome
Clearance angle
Bevel angle
Honing
Types of hones
Stropping
Natural dyes
Synthetic dyes
Chromophores
Auxochrome
Chromogen
Dye
Chromophores
Auxochromes
Dye modifiers
Lake
Oxidizing agents
Alum hematoxylin
Iron hematoxylin
Tungsten hematoxylin
Copper hematoxylin
Eosin (Eosin Y)
Coplin jar
Slotted staining dishes
Metal/glass staining racks/
carriers
H & E staining steps
Benzidine
Acridine orange
Gentian violet
Congo red
Iodine
Malachite green
Janus green
Night blue
Victoria blue
Lysochromes
Adhesives
Mounting media
Stains on skin
Restaining of old sections
Broken slides
mounting media
2. If replacement not possible, the section (if intact) may be transferred to
another slide:
Broken slide Xylene (rem. coverslip) incubate (rem. mountant) 6 parts
butyl acetate + 1 part durofix incubate (mixture film) Cut the film
around the section Cold H2O until the film & section float off Film w/
section mount on a clean slide incubate butyl acetate xylene
mount
Ringing
Enzyme histochemistry
IgG
Polyclonal
Monoclonal
Epithelial Tumor Markers
(+) CK 7
(-) CK 20
Shortcut: Xi6B1DiCuCoFSMiBXM
Broken slide Xylene Incubate 6 Butyl acetate + 1 Durofix Incubate
Cut film Cold H2O to float film & section Film w/ section mount
incubate butyl acetate xylene mount
Sealing the margins of the coverslip
Prevent escape/evaporation of fluid
Immobilize the coverslip
Prevent sticking of slides
a. Kronig cement = 2 parts paraffin + 4-9 parts colophonium resin
b. Durofix (cellulose adhesives)
Immunohistochemistry
Trypsin & protease = most commonly used
Most commonly used antibody
Rabbits (1) > Goat (2) > Pig (3) > Sheep (4) > Horse (5) > Guinea pig (6)
Mice
LUBO = paired
Lung
Uterus
Breast
Ovary
(+) CK 20
Stomach
(-) CK 7
Colon
(+) CK 7
Transitional cell carcinoma of the bladder
(+) CK 20
Mucinous ovarian tumor
(-) CK 7
HCC
(-) CK 20
RCC
SCC
Thyroid carcinoma
Prostatic adenocarcinoma
EMA (Epithelial membrane (+) carcinoma BuLK = paired
antigen)
Breast
Lungs
Kidney
CEA
Oncofetal antigen
GI carcinoma
Differentiates adenocarcinoma (+) & mesothelioma (-)
TTF-1 (Thyroid
Differentiates lung adenocarcinoma & mesothelioma
Transcription Factor)
(+): Thyroid, lung, neuroendocrine tumors
PSA
Prostate cancer
Intermediate Filament Markers
Actin
Smooth muscle
Skeletal muscle
lec.mt 04 |Page | 278
Vimentin
Desmin
GFAP (Glial Fibrillary Acidic
Protein)
NF (Neurofilament)
S100 protein
Neuroendocrine Markers
NSE (Neuron-specific
enolase)
Others
Cardiac muscle
Melanomas
Schwannomas
Leiomyoma (smooth muscle)
Rhabdomyosarcoma (skeletal muscle)
Astrocytoma
Neuroblastoma
Ganglioneuromas
Neuroma
Chemodectoma
Pheochromocytoma
Low MW Ca2+-binding protein
CNS glial cells, Schwann cells
Strong evidence of neural/neuroendocrine differentiation
Chromogranin
Synaptophysin
Synthesized by syncytiotrophoblasts
Choriocarcinoma
AFP
Endodermal sinus tumors showing yolk sac differentiation
PLAP (Placenta-like ALP)
Germinomas
Mesenchymal Tumor Markers
Myogenic tumors
Myo-D1
Myoglobin
Myogenin
Fibrohistiocytic tumors
-Vascular tumors
Factor VII-related antigen
CD31
UEA: Ulex europaeus I
Melanomas
-Lymphomas
LCA: Leukocyte common antigen (CD45)
Cell Proliferation Markers
Ki67
MIB-1: reference monoclonal antibody for Ki67 demonstration
PCNA
Proliferating cell nuclear antigen
Controls
Positive control
Known
Contains antigen in question
Negative control
Done using a parallel section from the tissue
Internal tissue control
A.k.a. built-in control
Contains the target antigen
Other Topics
Faults During Tissue Processing
Brittle/hard tissue
Incomplete dehydration
lec.mt 04 |Page | 279
Insufficient impregnation
Insufficient clearing
Insufficient dehydration
Incomplete clearing & impregnation
Incomplete fixation
Incomplete impregnation
Contaminated wax
Block not cooled rapidly enough
Insufficient paraffin impregnation
Surface & edges of block not parallel
Wax too hard
Knife tilted too much
Thick sections
Dull knife
Blunt knife
Dirty knife edge
Irregular knife edge
Edges of block are not parallel
Knife not parallel to the block
Impure paraffin
Blunt/dull knife
Block is warm & soft
Knife edge coated w/ paraffin
Thin sections
Microtome screw is loose
Tilt: vertical
Bevel of knife is lost
Incorrect sharpening
Bubble/dirt
Hard spot in the tissue (Ca2+)
Screw/holder is loose
Large & hard blocks
Static electricity
Dirty knife edge
Dull knife edge
Ribbon is split
Nicks/damage on knife
Dirty embedding
Dirty knife
Blunt knife
Stains
Substance Stained
(+) Color/Result
CHO, Glycogen, Mucins,
PAS (+):Magenta red
Bacteria & Fungi,
basement membrane
Glycogen
Red
Best Carmine
Glycogen
Bright red
Glycogen
Mahogany brown
Alcian blue
Acid mucins
Blue
Alcian Blue-PAS
Any mucins
(acid/neutral)
Acid MPS
Sulfated mucins
Carboxylated mucins
Cryptococcus neoformans
Mucins
Acid mucins
Acid mucins/MPS
Fungi
Stain
PAS
Lipids
Lipids (TAG)
Oil red O
Osmium tetroxide
Nile blue sulfate method
Lipids
Lipids
Neutral fat
Cholesterin esters
Cholesterin fatty acids
Fatty acids & soap
Cerebrosides
Brilliant red
Black
= Pinkish red
= Light red
= Light red
= Deep blue to violet
= Light blue
Sulfatide
Borohydride-PeriodicSchiff method
Alkaline fast-green method
Gangliosides
Avoid Ehrlichs
hematoxylin
Dark blue
Acid MPS: black
Fungi: greenish red
fluorescence
Blue black
red
Histones
Protamines
Cystine
Cysteine
Arginine
Alkaline phosphatase
Acid phosphatase
5-nucleotidase
ATPase
ATPase
Nonspecific esterase
Comments
Basic fuchsin: essential
component of Schiff
reagent
Method of choice for
glycogen staining
Selective & highly
specific for glycogen
Obsolete
Not specific for glycogen
Avoid celloidinization of
slides
Avoid Ehrlichs
hematoxylin
Green
Blue-green
Orange-red
Brownish-black
Black
Blackish brown deposits
Dark brownish-black ppt
Cobalt phosphate ppt
Reddish brown
Stain
Indoxyl acetate method
Tetrazolium method
Feulgen technique
Substance Stained
Nonspecific esterase
Monoamine oxidase
DNA
(+) Color/Result
Blue
Bluish black
Red-purple
Methyl green-pyronin
RNA
DNA
Reticulin fibers
Collagen
Muscle, cytoplasm, RBC,
fibrin
Collagen & mucus
Muscle, RBC & keratin
Collagen fibers,
cytoplasm, fibroglia
fibrils, axon cylinders,
neuroglia
Elastic fibers
RBCs, myelin sheets
CT
Glomerular basement
membrane
Amyloid & mucous
colloid
Elastic fibers
Elastic fibers
Elastic fibers
Elastic fibers
Fibrin & CT
RBC
RBCs
Muscle
Collagen
Fibrin
Fibrin, muscle striations,
neuroglia, amoeba
RBCs
Myelin
Collagen, osteoid,
cartilage, elastic fibers
Amyloid
Amyloid
= Pink/deep red
= Yellow
Amyloid
Yellow fluorescence
Muscle fibers
Collagen
Muscles, RBC
Collagen
= Red
= Green
= Red
= Yellow
Gomoris silver
impregnation stain
Van Giesons stain
Massons trichrome stain
Mallorys aniline blue
Azocarmine
Weigerts
Verhoeffs
Taenzer-Unna-Orcein mtd
Krajians technique
Martius-Scarlet-Blue
Mallorys PTAH
Congo red
Methyl violet-crystal violet
method
Thioflavin-T fluorescent
staining
Modified Gomoris
Trichrome stain
Lissamine fast red
= Blue
= Red
= Red
Comments
Most reliable & specific
histochemical staining
technique for DNA
Contains Schiffs reagent
Reticulin = Argyrophilic
(silver stain)
Contains acid fuchsin &
picric acid
= Pale pink/yellow
= Yellow
= Deep blue
Dark-blue/blue-black
Black
Dark-brown
= Bright red
= Dark blue
= Orange-yellow
= Yellow
= Red
= Blue
= Red
= Dark blue
Heidenhains
modification of Mallorys
aniline blue stain
Rapid method
Early fibrin = yellow
Old fibrin = blue
= Blue
= Lighter blue
= Deep brownish-red
Red
Purplish red
Stain
Schmorls Picro-Thionin
method
Substance Stained
Lacunae & canaliculi
Bone matrix
Bielschowskys technique
(+) Color/Result
= Dark brown-black
= Yellow/brownishyellow
= Black on a grayish BG
Comments
= Lightly stained
Diagnosis of Alzheimers
disease
= Black
= Black
= Light brown
= Black
= Black
Deep blue
Deep blue
Purple
= Purple-dark blue
= Pale purple blue
Blue black
Blue-green
Black
Black on a light
brownish BG
Deep blue
Bright blue
Blue
Dark blue
Emerald to blue green
Blue-purple then green
Depend on the oxidation
of the pigment to green
biliverdin by iodine
Bile, lipofuscins,
melanin, argentaffin
cells, chromaffin, thyroid
colloid
Lipofuscin
Hemofuscin
Melanin
Argentaffin cell granules
Dark blue
Calcium
Black
Copper
Red to orange-red
Purple
Red
= Black
= Black
Argentaffin reaction:
melanin reduces
ammoniacal silver
solutions w/o use of a
reducer
Stain
Gram-Twort stain
Substance Stained
Gram (+) organisms
Gram (-) organisms
RBCs
Elastic fibers
Gram (+) bacteria
Gram (-) bacteria
M. leprae
H. pylori
H. pylori
L. pneumophila &
spirochetes
Levaditis method
Spirochetes
Modified Steiner & Steiner
Spirochetes, Donovan
technique
bodies, fungi, bacteria
Warthin-Starry method
Spirochetes
Grocott Methenamine Silver Fungi
In situ hybridization
PCR
Chondrocalcinosis
Kardasewitsch method
0.1% urea + 5% NaSO4
Metastasis
Degree of localization
Dunn-Thompson
K2MnO4
H2 O 2
Hellys
Formalin ammonium
bromide
Alcohol as 1 fixative
Glutaraldehyde
Carnoys
Orths
Zenkers
Formaldehyde
Ethanol
(+) Color/Result
= Blue-black
= Pink-red
= Green
= Black
= Blue
= Red
Golden yellow
Dark blue against blue
BG
Blue-violet
Dark brown to black
Comments
Black on a yellowish BG
Black
Black
= Sharply outlined I
black
= Gray-black
= Old rose
= Yellow
Bright red
HBsAg
Brown-black
Bacteria
= Blue
Recommended for blood
Mast cell granules
= Deep blue
and BM parasites,
Eosinophilic granules
= Red
inclusion conjunctivitis,
Nuclei
= Blue
Toxoplasma, spirochetes
Cytoplasm
= Pink
& other bacteria
Most sensitive technique for identifying DNA
DNA amplification
Pseudogout
Pigment removal
70% ETOH + 28% NH3 water
Remove yellow color of HNO3
Most definitive of malignancy
Most reliable indicator of prognosis of malignant tumors
Hgb = emerald green
Removes excess melanin
Contains formalin, K2CrO4 and HAc
Fixative for CNS (gold/silver stain)
Increased tissue shrinkage
Not satisfactory for PAS
Nonaqueous fixative
Pheochromocytoma
PTAH for cross-striations
Wash tissue in water after fixation in Zenkers
Combines w/ amino group
Nonadditive fixative
lec.mt 04 |Page | 285
pH >6.0 (formalin)
Universal solvents
Soft paraffin
Weigerts hematoxylin
Natural resins (mounting)
Formalin-alcohol
Churukian-Schenk
technique
Masson-Fontana
Muscle biopsies
Paraffin sections
Zambonis PAF
Glutaraldehyde
10% NBF
Paraformaldehyde
Warthin-Starry stain
Iris diaphragm
Substage condenser
Pathology
Cornelius Celsus
Littoral cells
Hoffbauer cells
Cancer
Biohazards
Mercuric chloride
According to the presence
of a mordant
According to the presence
of differentiator
According to the resultant
color
Vital staining
Neurons
Biconcave
120 mm
Plane wedge
100 mm
Carmine
Best Carmine
Mucicarmine
Base-sledge
Rotary
Rocking
Rotary
Sliding
Base-sledge
Picrocarmine
Carmine + Picric acid = for neuropathological studies
Dukes staging for neoplasia One of the most frequently applied for staging individual tumors
of the rectum
Biopsy
Biopsy
Excision and exam (living subject)
Preferred: perform the biopsy at the periphery of the tumor (advancing tumor
margin)
Types of Biopsy
Exfoliative cytology
Desquamated cells
Sex hormonal status in females
Sex chromatin phenotype
Excisional biopsy
Complete removal of a lesion
Most reliable
Incisional biopsy
Removal of part of a lesion/small piece of tumor directly incising the tumor
capsule
Preferred for large tumors that cant be excised completely
Needle biopsy
Aspiration of fluid
Bite biopsy
Small pcs of tumor are removed w/ special forceps
Cutaneous biopsy
Skin fragments
Punch biopsy
For specimens >2mm embed in a single paraffin block
Shave biopsy
Curettage specimens
Wedge biopsy
Specimen is subdivided w/ a razor blade
Marginal excision
Shell-out end